House Approves Letting Pharmacists Oversee Six Times As Many Technicians

A bill the House passed on Wednesday would increase the number of pharmacy technicians each pharmacist can supervise. Critics of the bill say it’s putting corporate profits ahead of patient safety.

Pharmacists are ultimately responsible for signing off on all medication orders, whether they personally fill them or a trained pharmacy technician fills them under their supervision. Currently, pharmacies can petition the State Board of Pharmacy to have each pharmacist supervise up to three technicians. But the bill would allow up to six techs per pharmacist without board approval.

And former CEO of the Florida Society of Health System Pharmacists, Mike McQuone, said, that increase could hurt patients. He said, at Board of Pharmacy meetings every month, he watches pharmacists being disciplined for medication errors.

He said, “The pharmacist didn’t go to work that day and say, ‘I think I’ll commit an error.’ But because of distractions, because of the work process, because of the volume of that store, because of other issues, medication errors are resulting. And that’s under a 3-to-1 [ratio]. I’ll let you decide whether it would be safer under a 6-to-1.”

The bill has the support of the Florida Retail Federation, which represents several pharmacy chains, including Walgreen’s, CVS and Publix. If pharmacies hire more low-paid techs, their profits could rise because they could sell more medicine.

But Shannon Wedikind, representing Walgreen’s, says the chain disagrees that allowing more techs per pharmacist puts patients at risk. He says, Walgreen’s operates in several states without any mandated ratios.

“We asked our national director of quality assurance to compare quality between states that currently have unlimited ratios, 6-to-1 ratios, or 3-to-1 ratios, and Walgreen’s has not found any difference in quality across any of these states,” he said.

McQuone said, he supports the idea of giving corporations some flexibility, but only with more oversight. His biggest problem with the bill is that the Board of Pharmacy, the agency tasked with protecting the public, would not have a say until the pharmacist-tech ratio goes higher than 1-to-6.

But Rep. Joe Gibbons, a Broward County Democrat who voted for the bill in its last committee, said the bill can’t force pharmacists to do anything.

“If a pharmacist crumbles under pressure from a corporation, maybe they need to go work somewhere else," he said, “because when I sign my name, I’m saying—regardless of pressure, regardless of profit margin, regardless of whether it’s one or six—I’m saying that this is right.”

But McQuone said, pharmacists don’t have as much of a choice in a market heavily dominated by big chains. Staffing decisions are often made at a level far above the individual pharmacist’s head.

“So the actual decision by any pharmacist under any circumstances is he has two choices: take it or leave it. The only ‘leave it’ is that he would, more than likely, be moving to another chain, who would be in the same or similar corporate posture,” he said.

One member who voted against the bill on the House floor, Broward County Democrat Elaine Schwartz, said she couldn’t support the increased ratio without requiring techs to have more training. McQuone said, that’s something hospital pharmacists have wanted for years.

But bill sponsor Travis Hutson, a Republican from Flagler County, said there’s no scientific evidence the increase will result in more mistakes.